Abstract

Multiple primary cancers in a single individual are rare and usually challenging for effective treatments. Identification common cancer gene driver mutations and targets for patients with multiple primary malignant cancers will offer potential opportunities for effective personalized treatment. We have collected and analyzed tumor tissue samples from patients diagnosed with multiple primary cancers including lung cancer, kidney cancer, prostate cancer, and bone cancer from the Affiliated Zhongshan Hospital of Dalian University. Deep sequencing of the tumor samples was performed using TruSeq Amplicon - Cancer Panel (TSACP) which covers 48 cancer genes with more than 200 mutation hotspots. We have found that TP53 (75%), PIK3CA (50%), KDR(50%), VHL(50%), KRAS (25%), , FGFR(30%), EGFR(25%), HER2(25%) and ATM (25%) mutations are among the most common gene alterations across different types of primary cancers, they share some common cancer signaling pathways. Missense exon variation(4.13%) , non-coding exone variation(2.8%), and frameshift variation (0.41%) are among the most frequent alterations for functional effects. Targeted and chemotherapies have been recommended for personalized cancer treatments and circulating tumor cells (CTC) enumeration was conducted to monitor the prognosis of therapeutic efficacy.